| Objective1.To observe the changes of serum adrenomedullin(ADM), CA199, fastinginsulin(FINS), HOMA-IR levels among patients with type2diabetes when treated bydifferent therapies of acarbose or insulinoid, and the relationship between ADM,CA199, FINS, HOMA-IR and glucose and lipid metabolism.2.To observe the effects of metformin, aerobic exercise or thecombination of both interventions on metabolic parameters and chemerin proteinexpression levels in omental adipose tissue (OAT) and subcutaneus adiposetissue(SAT) of high-fat-diet induced obesity rats and to explore the relationshipbetween ADM and obesity-related metabolic disorders.Methods1.Ninety type2diabetes patients received acarbose (Group A,n=30),protamine zinc and insulin lispro mixed injection (25R)(Group B,n=30), orshort-term subcutaneous insulin aspart pump therapy (Group C,n=30). Clinical datawere recorded. Fasting blood glucose(FBG), postprandial blood glucose(PBG), totalcholesterol(TC), triglyceride(TG), very low density lipoprotein(VLDL) were detectedbefore and after treatment.Serum ADM, CA199, fasting insulin(FINS) levels beforeand after treatment were measured by enzyme-linked immunosorbent assay (ELISA).And evaluate the HOMA-IR.2. Seventy SD rats were randomly divided into two groups in which10ratswere fed with normal control diet as the NC group, and the remaining60were fedwith high fat diet as the HD group. Obesity model(n=40) was established from HD group and was randomly divided into four groups: high fat group(HF,n=10), aerobicgroup(SWI,n=10), metformin group(MET,n=10), and the combination of metforminand aerobic group(SAM,n=10). Body weight(BW), FBG, TCH, TG, VLDL, FINSwere detected before and after6weeks of treatment. HOMA-IR were evaluated.ADM protein expression levels in OAT and SAT were determined by Western Blot.Results1.①After treatment, the FBG, PBG of the patients in each group decreased，HbA1C of the patients in Group A and Group B decreased (P<0.01);②The serumFINS，ADM and CA199and HOMA-IR levels decreased after the treatment. TheHOMA-IR levels decreased after the treatment. The differences weresignificant(P<0.01);③The changed levels of ADM and FBG in each group weresignificantly different (P<0.01).2.①After16weeks high fat diet induced obesity, the levels of BW, FBG,FINS, TCH, TG and HOMA-IR in each group were higher significantly in contrast tothose in NC group (P<0.05). ADM protein expression levels of obesity group in OATand SAT higher than ND group(P<0.05).②After6weeks intervention, the levels ofBW, FBG, FINS,TCH，TG, VLDL and HOMA-IR in SWI group, MET group andSAM group were down-regulated compared to those in HF group(P<0.05), but theparameters showed no difference among the three intervention groups (P>0.05).③InOAT and SAT, ADM expression levels of the group of SWI, MET and SAM,especially SAM group decreased after intervention(P<0.05).Conclusion1.①With the decrease of blood glucose level among patients with type2diabetes, their ADM, CA199, FINS and HOMA-IR levels decrease, which may beinvolved in glucose and lipid metabolism.②Compare to the treatment of acarbose,the therapy of insulinoid, especially continuous subcutaneous insulin aspart infusionhave the better effects in reducing the blood glucose and improving IR.2.①High fat diet could induce SD rats obesity and also increase theADM protein expression levels in OAT and SAT.②Metformin, aerobic exercise and the combination of both intervention could down-regulate the ADM proteinexpression levels in OAT and SAT and improve metabolic disorders remarkably inobesity rats.③ADM may be a key participant element in the etiology andpathophysiology of obesity-related metabolic disorders. |
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